A watch-and-wait strategy or local excision in complete clinical responders after radiation for early-stage rectal cancer

Abstract

In The Lancet Healthy Longevity, Alexandra Gilbert and colleagues1 reported quality-of-life and functional outcomes among older patients with early-stage rectal cancer after short-course radiotherapy (SCRT), followed by transanal endoscopic microsurgery, based on the TREC initiative. Among 88 patients included in the analysis, 61 (69%) individuals were allocated to organ preservation through the non-randomised registry on the basis of older age, frailty, or comorbidities. To capture treatment outcomes in this particular cohort of patients who were unfit for radical surgery, data on patient-reported acute and late toxicity, anorectal function, and quality of life at baseline and during 36 months of follow-up were compared with age-matched controls without a cancer diagnosis from the UK general population, and also with the randomised TREC cohort that comprised younger patients with early-stage rectal cancer.